Você está na página 1de 32

Intravenous Therapy

Julie Ann Marie Dalisay-Uy, RN

Page 1

Intravenous Therapy
Could be continuous or intermittent and The fastest way of delivering fluids The giving of liquid substances directly medications throughout the body. into a vein.

Page 2

Introduction

Page 3

1.1 History
RA 9173: Philippine Nursing Act of 2002 ANSAP (article VI sec 28) Association of Nursing Service Administrators of the Philippines

Page 4

Nursing Standards on Intravenous Practice


- objectives
1. Serve as a guide for nurses in providing 3.2. Promote the application ofto patients, of Recognize the nursing careimplications ethico-legal principles safeunderlying the administration of IV and quality IV Therapy relativeTherapy to IV therapy

Page 5

Nursing Standards on Intravenous Practice


- Scope of Nursing Practice
 Proficient Nursing Law RA: 9173use, care,  Appropriate to infection control Adherence documentation relevant to the Perform peripheral ability in the practices  technical venipuncture, excluding   Change IV on the blood medication  Administer blood andphysicians written as  determinesite, tubing and dressings solution and  Basedadministration components maintenance and evaluationtermination of Observation and assessment of all adverse preparation, of subclavianand cutIV for  Carry out the Physicians prescription the insertion prepare, initiate, monitor and and prescribed by the of solutions, incompatibilities physician down prescription, flowforms of IVT Establish equipment. rates reactions related to IVT and initiation of of all IVT catheters. blood and therapy medications,terminate ofblood components Nursing management IVinterventions appropriate nursing patients receiving as prescribed by the physician IV therapy and peripheral/ parenteral nutrition in various set-ups
Page 6

Iv Insertion
The entry of a needle/ catheter/ cannula into a vein based on a physicians written prescription.

Page 7

Indications
 to maintain hydration  for parenteral nutrition For administration of medications For the transfusion of blood and blood products

Page 8

ContraIndications
 administration of irritant fluids or medications through peripheral access

Page 9

Key Points Prior to Initiation


 Patient assessment - duration of therapy  physicians order cannula size -- type, amount of solution - and frequency vein/ skin - type dosecondition of the of medications to be incorporated or pushed - type of solution - pts-LOC, flow rateage The activity, - dominant arm - clinical status of the pt. Page 10

Considerations for site selection


 Sclerotic andPatients activity extremities avoid using veins in the lower rest notthe  phlebitic does should in be Size of the vein should be large enough Ensure catheter tips veins not  Selectinsertion distally then movestraight, a vein that is considerably up  startto sustain sufficient blood flow the  catheter size flexion area, asselected inhibit IV flow this would not rolling and isextremity an area where it found in  veinPurpose and guidelines the selecting the dorsal preferencefor hand, portion of  inPatients type of infusion Follow the is normally splinted general forearm and antecubital fossa are suitable  selectvein clients non dominant hand the by palpation and inspection, a Cannula Assess Duration of therapy sites - Should feel patients age firm, elastic, engorged and round not hard, and prior surgery  patients diagnosis flat or bumpy.
Page 11

Guidelines in Choosing a Cannula


 -1/4 inch in lenth

 a smaller diameter  20-22 guage for most IV fluids, larger guage for viscous solutions, guage 18 for blood transfusions
Page 12

Site Selection

Page 13

Techniques to enhance vein visualization


 gravity  fist clenching  application of warm compress  application of tourniquet/ application of BP cuff  skin stimulation  translumination
Page 14

Equipment needed for Ivt

Page 15

Types and uses of IV cannula


 Butterfly/ steel winged  Over-the-needle: - Short steel needles with plastic wing - requires the additional step of needles advancing the catheter infiltrates vein - Easy to insert, but also into the easily after venipuncture small and non pliable because they are - - Should be preferred limitedbutterfly frequently used for a over time only due to increased risk for vein injury and needles because they are less likely infiltration to cause infiltration
Page 16

Types of Solutions

Page 17

Other types
- crystalloids
Solutions that contain electroytes May be used for fluid volume replacement D5IMB, D5NM, D5NR

Page 18

Other types
- colloids
Also called plasma expanders Pull fluid from the interstitial compartment into the vascular compartment used to increase the vascular volume rapidly albumin
Page 19

Intravenous Drip
The continuous infusion of fluids, with or without medications, through and IV access device.

Page 20

Intermittent Infusion
Used when a patient requires medications only at certain times and does not require additional fluid.

Page 21

Intermittent Infusion
Used when a patient requires medications only at certain times and does not require additional fluid.

Page 22

Golden Rules in Drug Administration


Administer the right drug to the right Administer the rightdrug you administer drug Administerthe right dose right the drug Administer patient theby historyis Document the rightright drugright time eachabout at thethehe Administer Take aout if the patient has any drug complete drug Teach your patient drug Find Be aware of the potential drug-drug or route receiving allergies drug food interactions

Page 23

Steps in Iv Insertion and Removal

Page 24

Problems encountered in IVT

Page 25

Extravasation

Is the accidental administration of IV infused medicinal drugs to the surrounding tissue, either by leakage or direct infusion

Page 26

Infiltration

Blanching of the skin, with pain at the site, cool to touch, decreased infusion rate

Page 27

Thrombophlebitis
Hard and cordlike vein, with tenderness at the site. Catheters placed in the veins that overlay joints are more likely to cause thrombophlebitis
Page 28

Embolism
A blood clot or other solid mass, or an air bubble delivered into the circulation via the IV site or cannula

Page 29

Infection on Site
Any break in the skin carries a risk of infection. Moisture introduced to unprotected IV sites through washing or bathing substantially increases the infection risks.
Page 30

Bruising
May occur at any time during an episode of IV therapy

Page 31

Thank you!

Page 32